Caries and periodontal disease remain the main reasons for tooth loss worldwide, despite positive effects of preventive measures to reduce caries primarily through the application of fluoride. If detected early before demineralization of the tooth surface has reached the dentin, an incipient caries lesion can be cured by remineralization.
If however the lesion has progressed into the dentin, restorative procedures such as placing amalgam or composite fillings into the treated caries become necessary. Such restorative procedures are in general more invasive and represent a much greater expense to a patient or a third party provider than preventive or curative procedures. Thus, early detection of carious lesions is a key element in the prevention and treatment of dental caries.
Indices and methods of conducting surveys for the level of dental disease were developed between 1900 and 1950. Modern epidemiological studies began after that, and many reliable studies have been conducted since 1960. Concluding remarks of the Symposium of the ORCA Caries Diagnosis Working Group state that the development of methods for determining whether a carious lesion is stable or progressing is a priority in caries research.
The poor diagnostic performance of conventional caries detection methods has prompted the research community to develop quantitative detection methods, such as electrical conductance measurements, light scattering methods, and laser fluorescence methods, in addition to the X-ray technique which is the current standard. Motivations for this development include that quantitative methods detect lesions at an earlier stage than conventional methods, are more reliable than qualitative measurements, and provide methods for monitoring the course of disease in a way that is non-detrimental to the patient.
A systematic review of diagnostic methods prepared for the 2001 National Institutes of Health Consensus Development Conference on ‘Diagnosis and Management of Dental Caries through Life’ was unable to establish relative efficacies of various methods currently used to detect dental caries. New methods and criteria are needed for diagnosis and prognosis of caries and periodontal disease.